Die swanger vrou se keuse tot MIV-toetsing / I. Gerrits

Abstract:

The prevalence of HIV infection in pregnant women is still on the rise despite existing
preventive programmes aimed at reducing HIV-transmission. Voluntary counselling
and testing during pregnancy is the key entry point in the prevention of mother-to-child
transmission (Department of Health, 2000:16; Birdsall et al. 2004:3). Women
are often diagnosed as being HIV-positive for the first time when they attend
antenatal clinics and consent to HIV testing (UNAIDS, 1997).
The objective of this study was to determine the pregnant women's experiences of
voluntary counselling and testing (VCT) and to explore and describe the impeding
and facilitating factors that played a role in their choice whether or not to consent to
HIV testing after having received pre-test counselling. By understanding the
impeding and facilitating factors that play a role in the pregnant woman's choice to
undergo HIV testing, recommendations could be made to possibly improve the
uptake of HIV testing among pregnant women.
The population studied in this research consisted of pregnant women making use of
antenatal clinics in the Potchefstroom sub-district. Purposive sampling was used to
select participants with the assistance of mediators who were working in the local
clinics and the hospital. The sample size was determined by data saturation, which
was reached after 10 interviews.
A qualitative design was used and data was collected by means of semi-structured
interviews. Data analysis was carried out simultaneously with data collection. In
consensus discussions, the researcher and the co-coder reached consensus on the
main and sub-themes. The main themes are the facilitating and impeding factors
that play a role in the pregnant women's choice to undergo HIV testing.
Based on findings, it was concluded that facilitating and impeding factors that play a
role in the pregnant woman's choice to HIV testing do indeed exist. Impeding factors
identified were: fear of a positive status; fear of stigmatization and discrimination;
fear of lack of support; lack of opportunity to consider their choice to undergo HIV testing;
lack of trust that confidentiality will indeed be honoured; fear of knowing
possible positive HIV-status that can lead to feelings of depression and mental
anguish; differences between counsellors' and pregnant women's characteristics.
Facilitating factors consist of the desire to be aware of own HIV status; desire to
protect the baby; sufficient information and the importance of trust and confidentiality.
Recommendations were subsequently made to make HIV counselling and testing
services to pregnant women more user-friendly in order to facilitate the pregnant
woman in her choice concerning HIV-testing. Heeding these recommendations will
possibly lead to more pregnant women's HIV status being known by the time they go
into labour. Recommendations were made that pregnant women be counselled for
HIV testing during their first antenatal visit and the HIV-testing being offered to them
during the second visit. Research findings reveal that most pregnant women need
time to consider their choice to undergo HIV testing and to prepare themselves for
the test. Most pregnant women felt that they would possibly consent to HIV testing
during their second antenatal visit.